| Obiective To investigate the effects of taking different therapies on pancreaticβ-cell function and remission period of Chinese subjects with newly diagnosed type 2 diabetes mellitus(T2DM) after short-term continus subcutaneous insulin infusion (CSII).and to investigate the relevant factor of the long-term remission obtained from intensive insulin therapy on newly-disgnosed type 2 diabetes mellitus.Methods 200 patients with newly-disgnosed type 2 diabetes mellitus were chioced with fasting plasma glucose (FPG)≥10.0mmol/L,2-hour postprandial glycaemia (2hPG)≥15.0mmol/L, hemoglobim Alc (HbAlc)>8.0%. All patients achieved the glycaemic control target levels after CSII. Then these patients were divided into three groups, received additional insulin therapies including multiple injection of premixed insulin, Glargine insulin therapy with oral antidiabetic drugs (OADS) and OADS alone, respectively, and were monitored for three years to observe the variation of Homastasis model assessment for insulin resistance (Homa-IR=FPG×FINS/22.5),Homastasis model assessment forβ-cell function index[Homa-β=20×FINS/(FPG-3.5)] each group and the duration of blood glucose still reaching the standard after drugs including insulin withdrawal each group(the remission period), and calculate the remission rate, analyse the relevant factor with long-term remission obtained from intensive insulin therapy.Results 200 patients glycose were well controled after CSII therapy in (6.42±3.15) days. When blood glycous well controled, the total insulin doseage was (32.03±8.67) U daily., It was fonud no serious hypoglycemic reaction.The patients showed significantly lower levels of FPG,2hPG, Homa-IR after CSII(p<0.01) and increased levels of Homa-(3, fasting C-peptide(FCP) and fasting serum insulin(FINS) (p<0.01). After CSII, taked different therapies, in three groups, The overall remission rate was 67.0%(73/109),64.9%(24/37),64.8%(35/54), respectively. And the remission gained over 1 year took up 37.6%(41/109),32.4%(12/37),31.5%(17/54), gained over 2 years took up 26.6%(29/109),27.0%(10/37),25.9%(14/54), gained over 3 years took up 12.8%(14/109),10.8%(4/37),13.0%(7/54), respectively.there was no significant difference in each remission group(p>0.05). and it was found that there was no significant difference inβ-cell functions and remission period of these patients in each remission group at the first, the second, the third year of follow up(p>0.05). Spearman analysis and Multiple linear regression correlation analysis showed that FPG,2hPG level after CSII, the daily insulin dosage when the glycaemic control target level gained through CSII therapy,HomaIR and HbAlc (r=-0.412,-0.184,-0.343,-0.521 and -0.222, p<0.05) were negatively correlated with the remission event, meanwhil FCP, FINS, Homa(3 when blood glucose reaching the standard was positively associated with the long-term remission event(r=0.451,0.607 and 0.652, p<0.05), and BMI is nothing with the the long-term remission(p>0.05).Conclusions Shor-term intensive insulin therapy enable the remarkable hyperglycemia of the patients with newly-diagonsed T2DM rapidly controled,and can effectively improve pancreatic (3-cell functions; The pancreaticβ-cell functions and the lenth of the period of remission in partly patients with newly diagnosed T2DM after intensive insulin therapy are nothing with the different therapies continued after CSII; FPG level after intensive treatment, the daily insulin dosage when the glycaemic control target level gained through CSII therapy,FINS,HomaIR.Homaβwhen blood glucose reaching the standard are important influencing factors of the long-term remission event. |
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